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Voriconazole

Voriconazole is a triazole antifungal medicine. According to the voriconazole prescribing information, it is used in adults and children aged 2 years and older for invasive aspergillosis and for oesophageal candidiasis. It is also used for candidaemia in patients who are not neutropenic, together with disseminated Candida infections of the skin and Candida infections of the abdomen, kidney, bladder wall and wounds.

Vfend

Invasive Aspergillosis, Candidaemia

200mg

Developed to target serious fungal infections, this medication is indicated to address invasive aspergillosis and is utilised in systemic treatment protocols.

From$50.67/ tabletView

Key points

  • Around 21% of patients in therapeutic trials had abnormal vision, changes in colour vision or photophobia (sensitivity to light).
  • The liver breaks voriconazole down using three cytochrome P450 enzymes: CYP2C19, CYP2C9 and CYP3A4.
  • Voriconazole tablets include lactose monohydrate among their inactive ingredients.

How it works

Voriconazole is a triazole antifungal agent. Its primary mode of action, as described in the UK Summary of Product Characteristics for Vfend, is inhibition of fungal cytochrome P450-mediated 14 alpha-lanosterol demethylation, an essential step in fungal ergosterol biosynthesis. The build-up of other sterols alongside the loss of ergosterol from the fungal cell membrane may be responsible for voriconazole’s antifungal activity.

Safety specific to voriconazole

In clinical trials, there have been uncommon cases of serious hepatic reactions during treatment with voriconazole, including clinical hepatitis, cholestasis and fulminant hepatic failure, including fatalities. Serum transaminase levels and bilirubin are measured at the start of treatment and monitored at least weekly for the first month. Voriconazole has also been associated with prolongation of the QT interval on the electrocardiogram. The effect of voriconazole tablets on visual function is not known if treatment continues beyond 28 days. Severe cutaneous adverse reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms have been reported and can be life-threatening or fatal. Voriconazole can cause fetal harm when administered to a pregnant woman.

Further reading

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